We are fortunate to live in the centre of London, where we have access to some of the most up-to-date treatment for cancer. In the past few years cancer treatment has advanced rapidly, and oncologists have the diagnostic tools and drugs available that are were unknown even ten years ago.
But this does not mean we should be complacent. There is much still to be done, especially in the field of survivorship. I realised this when I developed breast cancer. So this is very much a personal overview of the situation in our Borough.
Patients have complained that once they leave hospital, they feel ‘abandoned’; there is no-one to turn to for all the problems and worries that side effects of drugs can cause. They are expected to ‘store’ these up and ask their Oncologist when they have their six-monthly check-up.
Patients are given strong drugs during chemotherapy treatment, then often handed hormonal drug tablets to be taken for five years. A doctor described these as ‘min-chemo’, and the side effects of these drugs are something that has caught the NHS on the hop. Side effects can cause temporary blindness, very heavy hot flushes which interrupt sleep, skin lesions that leave a bloody trail all over a body, and many other distressing symptoms. Patients can be bullied, with specialists brushing side effects aside with, “it’s your age”.
A recent NHS survey produced the horrifying statistic that over 60% of patients came off their drugs – either openly or on a “please don’t tell doctor that I throw the pills away” basis. A follow-up survey done in Irish hospitals showed that those coming off the pills with a higher percentage of recurring cancer.
Cancer support centres do a lot to offer patients support in handling problems, and we are able to make use of Maggie’s at Charing Cross, Cancerkin at the Royal Free, the Paul D’Auria Cancer Support Centre at Clapham Junction, The Haven in Fulham and St. Mary’s, Paddington.
You may notice that there is a huge hole in the centre of the Borough, and this needs to be addressed. There is a Macmillan centre at Chelsea and Westminster Hospital; this does a fantastic job with limited resources, but it is small and crammed into a corner of the ground floor.
However, David Cameron promised that cancer services would be ‘ring fenced’, and the Dept. Health is working on a scheme to give every cancer patient a ‘passport’ detailing all the treatment they underwent before they were discharged. It is suggested that this is taken to their GP, who then has all their notes for reference, and can take over care of that patient, dealing with side effects and overseeing their on-going care.
There are major flaws in this scheme, including :
- Doctors are only given 6 QOFs (these are the points that go towards their payment for services provided to the NHS) for seeing cancer patients. Diabetics and other conditions are worth up to 90 QOFs. When London surgery costs (rent, rates, staff transport, higher wages, etc) are taken into account, you can see that doctors may not allocate costly resources where there are few QOFs.
- Most doctors are not given any training in dealing with complex needs of cancer patients.
Prior to the election, Mark Simmonds (a Conservative spokesmen for health), loudly condemned the UK’s shameful record of post-cancer care and survival, when compared with other European countries, especially France. He said his party wanted to aim for the Swiss screening outcome (they have just bought down waiting time for screening from FIVE to THREE days – we aim for 14 in the UK).
Both of the Borough’s MP, Sir Malcolm Rifkind and Greg Hands, have supported Breakthrough Breast Cancer’s efforts to reduce screening waiting times, and to restore Lymphoedema treatment services in the Borough. Now the election is over, we need to build on this support, and, looking towards the future, forge links with French hospitals to learn from their cancer treatment.
I was lucky enough to be invited to the AGM of a French company that makes products helping cancer patients deal with side effects from drugs. Evolife products are undergoing clinical trials, but many are already prescribed to French patients – and if we learnt from them, patients could be helped to stay on drugs, and profit from the life-prolonging benefits of these powerful agents. Eurostar goes from up the road into the heart of Paris, and personally I would like to see a lot more to-ing and fro-ing between our medical teams.
However, there is a difference in our cultures. I found this out when I asked a group of French Oncologists if their hospitals had mixed wards. Gasping with horror, they asked “why would you want that?” And I had the hardest time explaining that no, I wasn’t a sex maniac – we did put men and women in the same ward sometimes (something I am working hard to eradicate).
After my treatment, I started a website called Having Fun After Cancer. Many of the treatments I received, particularly when I went to France, Germany and Italy, were fun as well as providing health benefits. Massages, skincare, and products that help mitigate side effects are provided as part of their health care. Often these are provided free by the state health system, rather than relying on charities.
Just before he retired, Lord Darzi mentioned that, taking insurance and taxes together, the French paid about the same as we did for the NHS, so using funds carefully it should be possible to work towards providing the same level of care, and hopefully increase our life expectancy after cancer.
The above article reflects my own opinions; it is not an official LINk opinion – only my own as a patient who has been very grateful for my care, but who would like others to have access to the same treatment I was given, but in many cases had to fight for this. It is too early to predict what will happen, but for a personal view of the political situation, see http://after-cancer.com/cancer-news-latest/will-the-nhs-under-the-conservative-coalition-suffer-or-prosper/